Photograph courtesy of Gerber Products Company
By Tom Ekman
April 26, 2017

Imagine this: A wealthy American woman in Beverly Hills goes online and orders her perfect child: tall, blue-eyed, intelligent, and disease-free. Nine months later, her baby—carried by an unknown surrogate overseas—is delivered happy and healthy to her doorstep. Parents have always wanted the best for their children – the best schools, the best toys, the best of what life has to offer. But what if you could actually buy a better child?

Superbabies are not here quite yet, but the genetic technology moved a quantum leap forward in 2014 with the invention of CRISPR/Cas9 – the “molecular scissors” for cutting-and-pasting the hereditary genes of mammals. This is no longer improving an individual – this is changing the species. And the human genome is being mapped out so precisely right now that in only a few years, it may be possible to purchase traits like athletic ability, musical talent, or math genius — on spec.

This could be a massive step forward for medicine. Imagine the possibility of wiping out genetic conditions like Down syndrome, cystic fibrosis or Sickle Cell. But unlike antibiotics or vaccinations – medical technologies that became cheap enough for the global population – reproductive technologies may remain financially out-of-reach for most people. Today, the IVF process in the U.S. may cost an infertile couple over $100,000. While the genetic screening of a given embryo is only $5,000, the tools to actually change those embryos could be very expensive, indeed.

And so the perfect baby might remain the domain of the very wealthy, and that makes a wide range of commentators very anxious. We might create a new caste system, with a high society of the genetically-enhanced. Or even a new species: Homo melorious (“improved man”). Should we stop this before it’s too late? Enhanced humans are inevitable. It’s how we get there – what standards and protections we put in place for our children – that matters.

One challenge is that the line between medical intervention and enhancement is blurry. For example, if we can alter traits related to muscular dystrophy by improving muscle growth – a procedure we have already carried out successfully with mice – what is to stop us from then seeking above-average muscularity? Why stop there — why not go for a super-athlete? The Olympic Committee is already discussing whether it will need to screen for genetic enhancement the same way it currently screens for performance-enhancing drugs.

Another consideration is the multi-billion-dollar, international trade in fertility tourism. Would-be parents flock to more-permissive countries (and states) such as California, where they can choose the sex of their child, or remove a surrogate’s name from the birth certificate. Consider the Greengold Baby, reported on NPR. The sperm came from Israel, where it was frozen and flown to Thailand to meet a South African egg donor. After the egg was fertilized, the embryo traveled to Nepal and was implanted in the Indian woman who served as the surrogate mother. When the 2015 earthquake hit Nepal, Israeli helicopters were flown in to rescue 26 Israeli babies carried by Indian surrogates.

The fundamental problem is that there is no worldwide agreement on assisted reproductive technology. But this, thankfully, can be changed. The 1989 U.N. Convention on the Rights of the Child has been signed by 174 countries – all but the United States. Currently, the Convention states that children have the right to know their biological origins and ancestry. As a result, European nations banned anonymity for sperm and egg donors over a decade ago. In the U.S., however, many states still allow donor anonymity.

The U.S. clearly needs to join the world community and sign the Convention. This would create a ripe moment for the Convention to be amended to address the new circumstances of assisted reproductive technology, such as genetic engineering.

Finally – and this is may be our biggest challenge – we need to be ready to make some difficult decisions about the future of our children. For example, the BCRA mutation, which alters a specific gene that normally inhibits tumors, gives women a 50% chance of getting breast cancer by age 40. Currently, IVF parents can screen for this gene using pre-implantation genetic diagnosis (PGD). While most parents consider the BCRA gene grounds for discarding this embryo, what if it was a 10% chance? Or a 1% chance?

The better we know our DNA, the more difficult it may be to decide what is a life worth living. And that is not a decision that should be left to market forces. These decisions about the genetic future of our species will require us to look deep inside our own humanity –our legal system and moral code, our faith and spirituality, and above all, our hopes for our children – and consider whether we are nurturing life, or playing God.

Tom Ekman is co-author, with Mary Ann Mason, of the book, Babies of Technology: Assisted Reproduction and the Right of the Child.

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